General Patient Care

What are some materials used in dermatology?

dermal punch + cutter, scalpel, gauze, incision and drainage tray

What are some materials used in endocrinology?

glucometers, alcohol pads, adhesive strips, test strips, lancets

What are some materials used in pulmonology?

peak flow meter, spirometry machine, disposable mouthpieces and nose clips

What are some materials used in neurology?

percussion hammer, tuning fork, penlight, tongue depressor

What are some materials used in OBGYN?

vaginal speculum and retractors, cytology kits, stich removal site, stirrups, handheld fetal machine

What is the supine position?

• flat on back with hands on sides

• examines anterior body

What is the prone position?

• on stomach with head to one side

• back exams

What is the dorsal recumbent position?

• flat on back with knees bent and feet flat

• anterior and genital areas

What is the lithotomy position?

• similar to recumbent but feet are placed in stirrups

• vaginal exams

What is the fowler’s position?

• patient sits on table with head raised to 90 degrees

• upper body exam

What is the semi-fowler’s position?

• head is raised to 45 degrees

• post surgical exams

What is the left lateral position?

• laying on side with right leg bent upward and left leg slightly bent

• rectal, perirenal and pelvic exams, and enemas

What is the knee-chest position?

• kneeling with thighs at 90 degree angle and butt in air

• proctologic and vaginal exams, and sigmoidoscopy procedures

Steps of Eye Instillation

1. gently pull down lower lid to expose the conjunctival sac

2. administer treatment with the dominant hand resting on forehead; medial to lateral

3. have patient close their eyes and clean excess medication

Steps of Ear Instillation

1. give number of prescribed drops ½ inch above the ear

2. have patient remain in position for 5 minutes

How should the ear be pulled during ear instillation?

• out and up for adults

• out and down for infants and children

What should be documented for medication allergies?

• med name

• amount of does taken prior to reaction

• strength

• patients reaction

• indication for med

• date and time of reaction

• route

What are critical devices?

devices that come in contact with blood or normally sterile tissues, such as forcepa

What are semi-critical devices?

come in contact with mucus membranes, such as endoscopes

What are non-critical devices?

contact unbroken skin, such as stethoscopes

What is reconstitution in medication preparation?

adding a liquid diluent to a powdered med to create a concentration

What technique ensures accurate withdrawal of medication from a vial?

1. wipe top with alcohol

2. inject air = to value needed

3. withdraw desired amount

What are premeasured syringes used for?

immunizations and emergency administration

What is a tuberculin syringe used for?

• accurately measure meds in very small volumes

• doses less than 0.5mL should use this syringe

How should refrigerated meds be stored?

35 - 46 degrees F

How should frozen meds be stored?

-58 - 5 degrees F

How often should fridge and freezer temperatures be checked?

daily

How should the med supply be rotated?

meds with shortest or soonest expiration date should be used first

What are the steps for eye irrigation?

1. warm the solution to normal temp

2. place patient in supine or fowler’s

3. clean eyelid from inner to outer canthus

4. pull lids gently and irrigate from inner to outer canthus

What are the steps for ear irrigation?

1. warm solution

2. position patient with affected ear facing up

3. cleanse outer ear and examine with otoscope if needed

4. gently insert the tip, spray solution until finished

5. drain residual fluid, dry the ear

What are some benefits of a CPOE?

• reduces human error potential

• improves clinical decision support

• improves order accuracy

What is the CPOE?

an electronic process that allows a provider to enter medical orders electronically

How should a mayo stand be positioned?

slightly above the waist and at least 12in from body

How should sterile packets be opened?

far flaps, sides, closest flap without reaching over

What part of the drape is sterile?

• the inside

• 1in is nonsterile

What is a biopsy?

• surgical removal of tissue for microscope exam

• diagnoses cancer, skin conditions

What is an endoscopy?

views hollow organ or body with endoscope

What is a colposcopy?

• exam of vagina and cervix

• examine abnormal tissue

What is cryosurgery?

destroys abnormal tissue using cold liquid or cryoprobe

What is incision and drainage?

• lancing fluid or pressure buildup

• helps identify infection cause

Where are absorbable sutures used?

tissues beneath the skin

Where are nonabsorbable sutures?

skin surfaces

How long does suture absorption occurs?

5-20 days after insertion

How are sutures sized?

the more 0s, the smaller gauge

When do staples need to be removed?

within 4-14 days

What are the benefits of staples?

can shorten closure time and rapidly close an incision

What are the steps for suture removal?

1. prepare a sterile field and clean area with antiseptic

2. use suture scissors and cut the suture below the knot and close to the skin

3. remove other sutures until they’re gone

4. pull long remaining suture out

What are the steps for staple removal?

1. place lower tip of staple remover under the 2nd staple

2. squeeze handles until it’s completely closed

3. clean wound with antiseptic

4. dry and dress wound

What is the treatment for hypoglycemia?

consume foods or liquids high in glucose

What is the treatment for hypovolemic shock?

control blood loss, blood transfusion, IV

What is the treatment for syncope?

ammonia capsules 6in away from patient’s nose

What are sprains?

stretched or torn ligament

What are strains?

stretched or torn muscle or tendon

What is a simple (closed) fracture?

fracture doesn’t penetrate skin

What is an open (compound) fracture?

fracture breaks through skin

What is an abrasion?

scraping away outer skin, heals without scarring

What is an incision?

smooth cut from sharp material

What is a laceration?

irregularly torn edges, can cause bleeding and scarring

What is a puncture?

made from sharp objects, risk of infection and scarring

What is the inflammatory phase?

• 3-4 days

• pain, swelling, blood clot forms

What is the proliferating phase?

• 4-21 days

• fibrin threads pull edges together, scab begins to form

What is the maturation phase?

• 21 - 2yrs

• tissue strengthen and tighten wound, forming scar

What is a first-degree burn?

affects outer skin, red and discolored

What is a second-degree burn?

injures underlying tissue

What is a third-degree burn?

can damage nerves and bones

What is a fourth-degree burn?

all skin layers, destroyed nerve endings

How can prescriptions be sent to the pharmacy?

fax server or electronic transmissions

What are components of electronically generated prescriptions?

• time and date of transmission

• name of pharmacy

• DEA number

• phone number of provider